Virtually every runner has experienced or knows of someone that has experienced the dreaded plantar fasciitis. Even you’re not a runner, you’ve likely know of plantar fasciitis as it is the #1 cause of heel pain.
Anatomy of Plantar Fasciitis
The plantar fascia is a strong fibrous band of tissue on the bottom side of the foot. The plantar fascia runs from the calcaneus (heel) and fans out to each of the metatarsal heads (base of each toe).
This fibrous tissue plays a critical role in establishing the longitudinal arch of a person’s foot. The arch of one’s foot allows us to absorb and transmit the forces more efficiently than a flat surface – similar to that of a spring.
Classically, plantar fasciitis manifests as intense heel pain that is worse with the first step out of bed in the morning. That heel pain is due to micro-tearing and subsequent inflammation of the plantar fascia. There are a multitude of reasons why one’s plantar fascia would develop tears, but we can think of them all in two broad categories:
– Increased tension through the plantar fascia
– Dysfunction within the secondary structures associated with establishing the arch
Increased tension through the plantar fascia is caused when a person has either tissue length inequalities or sliding surface dysfunction in the posterior chain of the lower extremity. Tissue length inequalities represent shortened soft tissues. Every tissue has a proper physiological length as well as sliding surface function. Sliding surface function represents that ability of our tissues to slide and glide across each other. When adhesions develop within or between our tissues, it limits the contractibility, slide, and glide of our soft tissues.
As stated before, the plantar fascia plays a role in establishing the arch of the foot. Another group of structures that are responsible for establishing that arch are the intrinsic muscles of the foot. The plantar fascia and the intrinsic muscles have a symbiotic relationship. They work together to accomplish a task – maintaining the arch. When one does not do its duty, the other must pick up the slack. Commonly, the intrinsic muscles become under-facilitated and dysfunctional.
Assessing risk for Plantar Fasciitis
Laying flat on back, pull toes and foot towards head (dorsiflexion). Keeping leg completely straight, pull hip into flexion. If you are unable to reach 90 degrees of hip flexion while keeping your knee extended and toes dorsiflexed, your posterior chain tissue function is inadequate.
Short Foot Lunge
Make way into low lunge position. While in low lunge position, activate the intrinsic muscles of the foot to “create” or emphasize the arch of the foot. If unable to actively create the arch, your intrinsic foot action is dysfunctional.
Addressing Inadequacies and Dysfunction
1. Hip Mob
2. Hamstring Mob
3. Calf Mob
4. Four-Toe Salute
5. Big-Toe Salute
6. Toe Splay
Application of these basic assessments and preventative measures will help you to adequately and efficiently avoid plantar fasciitis. These measures are the first step in any good rehabilitation program for plantar fasciitis. If you or someone you know is currently battling plantar fasciitis or other forms of heel pain don’t hesitate to give us a shout. Our goal is getting you out of pain as quickly as possible and guiding you through a complete rehabilitation program!